Is it legal to seek help outside the military?

A

Airforcematt

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While home on leave I recently sought mental health care outside the military to get a second opinion on some issues I'm dealing with. The psychiatrist diagnosed me with PTSD. Upon my return I spoke to my military psychiatrist who disagreed with the evaluation I got from the civilian and presented a fairly good case against it based on my symptoms and the DSM IV definition of PTST.

He did however make a statement which alarmed me. He said that as a Military member I am not ALLOWED to seek care outside the military - even if I pay for it out of my own pocket (which I did in this case) Is this true? It sounds like BS to me but I've been unable to find anything in writing either way.
 
If that were the case, Military One Source would not exist. They offer 12 free counseling sessions to any service member. There main reason for offering is that it stays outside of the military chain unless you are a danger to yourself, or others.

http://www.militaryonesource.mil
 
afmatt said:
While home on leave I recently sought mental health care outside the military to get a second opinion on some issues I'm dealing with. The psychiatrist diagnosed me with PTSD. Upon my return I spoke to my military psychiatrist who disagreed with the evaluation I got from the civilian and presented a fairly good case against it based on my symptoms and the DSM IV definition of PTST.

He did however make a statement which alarmed me. He said that as a Military member I am not ALLOWED to seek care outside the military - even if I pay for it out of my own pocket (which I did in this case) Is this true? It sounds like BS to me but I've been unable to find anything in writing either way.
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Not factual. You are in fact entitled to seek out appropriate care including outside the government facilities. Look into Tricare's patient bill of rights.
 
Personally I would take that to the Patient Advocate and IG, but that's just me, a wave maker.
 
I went to an independent civilian doc, paid out of pocket, the doc wrote a statement for me which helped get my BH condition listed as failing retention when I appealed.
 
i was treated by outside providers for my mental health and they provided me with a narsum that i used to apply for ssdi and that was in part used for my meb !!!
 
ranger2992 said:
If that were the case, Military One Source would not exist. They offer 12 free counseling sessions to any service member. There main reason for offering is that it stays outside of the military chain unless you are a danger to yourself, or others.

http://www.militaryonesource.mil
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correction: If you are diagnosed with a MH army one source are not allowed to provide care.
 
afmatt said:
While home on leave I recently sought mental health care outside the military to get a second opinion on some issues I'm dealing with. The psychiatrist diagnosed me with PTSD. Upon my return I spoke to my military psychiatrist who disagreed with the evaluation I got from the civilian and presented a fairly good case against it based on my symptoms and the DSM IV definition of PTST.

He did however make a statement which alarmed me. He said that as a Military member I am not ALLOWED to seek care outside the military - even if I pay for it out of my own pocket (which I did in this case) Is this true? It sounds like BS to me but I've been unable to find anything in writing either way.
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I have been under the care of a civilian Psychiatric and civilian psychologist for last 4 years. Usually some posts won't allow care under civilian psychiatric due to some medications that a civilian can prescribe while they are banned in the military and also some other therapies such as EMDR is not authorized by military while civilans recommend it.
 
afmatt, it is not illegal in any way. You have the right for a 2nd opinion, be it civilian or military. This doctor is pissed because you got a 2nd opinion without notifying him that you were doing so. You also have the right to include this information with your NARSUM submition to the PEB.
 
ranger2992 said:
If that were the case, Military One Source would not exist. They offer 12 free counseling sessions to any service member. There main reason for offering is that it stays outside of the military chain unless you are a danger to yourself, or others.

http://www.militaryonesource.mil
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While Military Onesource is a GREAT resource and I have used their counselling services in the past they cannot/do not provide services should you actually have a mental health condition. They are more in the role of getting you through a death in the family or helping you with work stress. Not PTSD or anything that may require medication.

pittpan2005 said:
Personally I would take that to the Patient Advocate and IG, but that's just me, a wave maker.
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I'm tempted to... think I'm going to write up an MFR on it but keep it in my back pocket for now though. If I have to appeal at any point along the way I can bring up the fact that I was diagnosed by an outside provider to support my appeal.

grizz13 said:
afmatt, it is not illegal in any way. You have the right for a 2nd opinion, be it civilian or military. This doctor is pissed because you got a 2nd opinion without notifying him that you were doing so. You also have the right to include this information with your NARSUM submition to the PEB.
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Thanks for the info - jives with how I think he's reacting. He's also the one that told my PCM that "anxiety is not a
boardable condition. Only major depression or psychosis." http://www.pebforum.com/site/threads/anxiety-disorder-not-a-boardable-condition.17373/

Gotta love the military and the games they play...
 
afmatt said:
Thanks for the info - jives with how I think he's reacting. He's also the one that told my PCM that "anxiety is not a
boardable condition. Only major depression or psychosis." http://www.pebforum.com/site/threads/anxiety-disorder-not-a-boardable-condition.17373/

Gotta love the military and the games they play...
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Yeah I saw that post, it really sounds like this guy is full of himself and won't listen even if you are right. Tell him you want treatment from someone else because you feel that he doesn't have your best interest in mind... I would love to see that reaction!!! (Which is something that you can do too FYI)
 
grizz13 said:
Yeah I saw that post, it really sounds like this guy is full of himself and won't listen even if you are right. Tell him you want treatment from someone else because you feel that he doesn't have your best interest in mind... I would love to see that reaction!!! (Which is something that you can do too FYI)
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Leaning that way honestly. If he is trying to intimidate me it seems to negate the trust that is supposed to be inherent with the counselling relationship. He's one deep at the base though so I'm not sure how they would handle that - I'm in Japan, it's not like they have a bunch of Psychiatrist's off base like in the states :/
 
That is a sticky situation, since he knows that he is the "one", he is going to be impossible to deal with. I hope this dude settles down...
 
Personal experience with medical professionals is you do not want to be submissive, but also not aggressive. You need to be able to explain what you need/want in a way they understand. The more you're able to speak at/on their level I have seen more mutual respect. It's a fine line because; 1. we aren't medical experts 2. sometimes they have a chip on their shoulder 3. sometimes we have a chip on our shoulder.

When I look back at how I went about "forcing" my requests on physicians sometimes it worked, other times it backfired. It's a learning game.

My wife is an RN and has worked in numerous specialities. She taught me better etiquette in dealing with doctors. She was the first to say don't be passive, but also understand what you're talking about and speak on their level. That shows the physician you have done some research (good research/valid sources) and understand what is happening.

Just my two cents.
 
pittpan2005 said:
Personal experience with medical professionals is you do not want to be submissive, but also not aggressive. You need to be able to explain what you need/want in a way they understand. The more you're able to speak at/on their level I have seen more mutual respect. It's a fine line because; 1. we aren't medical experts 2. sometimes they have a chip on their shoulder 3. sometimes we have a chip on our shoulder.

When I look back at how I went about "forcing" my requests on physicians sometimes it worked, other times it backfired. It's a learning game.

My wife is an RN and has worked in numerous specialities. She taught me better etiquette in dealing with doctors. She was the first to say don't be passive, but also understand what you're talking about and speak on their level. That shows the physician you have done some research (good research/valid sources) and understand what is happening.

Just my two cents.
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Thanks for the advice - I'm in the process of putting together an email to send to both providers laying out my concerns and quoting the relevant AFI's. I'm pretty sure my PCM will back me once I talk to him - we'll see how it plays out.
 
Sent an email out to my PCM and the MH doc asking for "clarification on boardable vs non boardable conditions" and pointing them towards portions of AFI 48-123 that "confused" me given the answer that Anxiety was not a boardable condition. Praying I get a positive reply soon!
 
Mine said the same thing. It's not that anxiety isn't a boardable condition, it's that you haven't jumped through all the hoops yet for a doctor at his level to be able to say it fails retention standards. The first half of the battle is getting the condition added to the 3947. The second half is getting them to say it's failing retention standards. In order to do that, you will need support statements from your chain of command specifically detailing how your mental health conditions impact your duty performance in your specific MOS. Then, you need to get a similar letter from your civilian mental health provider. You need to explain to him your duties and responsibilities, and have him write how your mental health condition makes you unable to perform them.

You will probably not sway your NARSUM writer, and you will probably not sway the "impartial" provider review doctor who works in the cubicle next to your first NARSUM writer, but if you have that stack of evidence in your favor when you appeal, it can work in your favor. I won an appeal that way just last week...
 
Mike1983 said:
Mine said the same thing. It's not that anxiety isn't a boardable condition, it's that you haven't jumped through all the hoops yet for a doctor at his level to be able to say it fails retention standards. The first half of the battle is getting the condition added to the 3947. The second half is getting them to say it's failing retention standards. In order to do that, you will need support statements from your chain of command specifically detailing how your mental health conditions impact your duty performance in your specific MOS. Then, you need to get a similar letter from your civilian mental health provider. You need to explain to him your duties and responsibilities, and have him write how your mental health condition makes you unable to perform them.

You will probably not sway your NARSUM writer, and you will probably not sway the "impartial" provider review doctor who works in the cubicle next to your first NARSUM writer, but if you have that stack of evidence in your favor when you appeal, it can work in your favor. I won an appeal that way just last week...
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Congrats on that! Nice job!
 
Mike1983 said:
Mine said the same thing. It's not that anxiety isn't a boardable condition, it's that you haven't jumped through all the hoops yet for a doctor at his level to be able to say it fails retention standards. The first half of the battle is getting the condition added to the 3947. The second half is getting them to say it's failing retention standards. In order to do that, you will need support statements from your chain of command specifically detailing how your mental health conditions impact your duty performance in your specific MOS. Then, you need to get a similar letter from your civilian mental health provider. You need to explain to him your duties and responsibilities, and have him write how your mental health condition makes you unable to perform them.

You will probably not sway your NARSUM writer, and you will probably not sway the "impartial" provider review doctor who works in the cubicle next to your first NARSUM writer, but if you have that stack of evidence in your favor when you appeal, it can work in your favor. I won an appeal that way just last week...
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Awesome feedback and congrats on your recent win :) I'm trying to remain hopeful that the local providers will do the right thing (or else my Anxiety will keep me awake all night) but I have no qualms of going down the route you went if it comes to that.
 
Figured an update to this thread is in order.

Went to my provider today. I'm currently being seen by the military psychiatrist mentioned above for meds and a second provider for my actual ongoing counselling. Recently I got ahold of my medical records which included a few notes from my MH sessions. They are chalking much of what I'm dealing with as simply stress + are backpedaling from anxiety disorder NOS and proceeding with the "Adjustment Disorder" shenanigans. After reading that I reached out to the Clinical Psychiatrist I met with in the states and asked her to write a letter detailing her diagnosis of me which she did (She thinks I have PTSD)

During my session with the second provider for a counselling session I mentioned the stateside psychiatrist in passing. Said provider stopped the session and asked me what I was talking about - apparently I hadn't mentioned my visit to him yet... Oops. He told me (much to my dismay and alarm) "you know that's a UCMJ violation right?" and "I've seen people get kicked out of the military for what you are telling me you did".

Now I was fairly confident after starting this thread that I was in the right on this because several of you who answered me have been around this block a time or three. That said I still wanted to be SURE since my whole MH team appears to view me as a Court Martial waiting to happen... So I went and had a nice talk with the Area Defense Counsel agreed that a UCMJ violation is not something I need to be worried about. I left there feeling a bit more secure in what I did but also pretty apprehensive in that I don't trust my MH team as far as I could throw them with my bad back. I'm thinking about speaking to the IG and/or patient advocate and seeing if I can get sent to another location for MH care. Has anyone ever done something like this successfully?
 
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